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Online Resumes with "Healthcare Payer"



Manager - 20 Years of Experience - Near 07082

PROFILE Senior business technology/information services manager. Expertise based on grounded experience and leadership to create and manage IT organizations. Extensive healthcare experience managing multi-state development teams for WEB portal applications. Managed and enhanced Outsourcing/Staff augmentation structures to support on-shore development teams. Managed several multi-state Internet/Intranet development teams for...

Tags for this Online Resume: Ramis, Tandem, VM, Application Development, Asynchronous Transfer Mode (ATM), Cms, HP, Infrastructure, Novell, software, it jobs, Healthcare Industry, Program Management

Director - 15 Years of Experience - Near 19438

QUALIFICATIONS SUMMARY Highly motivated healthcare insurance professional with 30+ years of management experience in the healthcare payer arena. Extensive background in healthcare operations, specifically claims, appeals, precertification, healthy lifestyles, case management and call centers. Candidate with proven record of exceeding management goals, implementing performance objectives and process improvements beyond expec...

Tags for this Online Resume: Home Health, Computer Aided Software Engineering, Customer Service, Inventory, Managed Care, Management, Inventory management, PEDIATRIC, Benefits, Blue Prints

Compliance Officer

QUALIFICATIONS SUMMARY Highly motivated healthcare insurance professional with 30+ years of management experience in the healthcare payer arena. Extensive background in healthcare operations, specifically claims, appeals, precertification, healthy lifestyles, case management and call centers. Candidate with proven record of exceeding management goals, implementing performance objectives and process improvements beyond expec...

Tags for this Online Resume: Home Health, Customer Service, Inventory, Managed Care, Management, Computer Aided Software Engineering, Inventory management, PEDIATRIC, Medicare, Pre-certifications

Claims Examiner

Summary To leverage my 15+ years of experience in the Healthcare Industry. Summary of Accomplishments Results oriented high-energy, hands-on professional with a successful record in the Healthcare field and Illinois Department of Human Services. For over 15 years as a contracted employee. In processing Medicaid applications & Medicare for patients who met eligibility criteria who did not have Medical Insurance as well as as...

Tags for this Online Resume: Applications, Payroll, Security, Bad Debt, Billing, Human Resources, Kronos, Kronos (Labor Mgmt Sys), Management, Benefits

Inside Sales Representative - 10 Years of Experience - Near 08824

ACCOMPLISHMENTS & SALES EXPERIENCE: * Negotiated contracts with vendors * Inside Sales, Marketing and Lead Generation * Portfolio Management & Financial Tools * Pipeline Sustainability * Analytics & Insight Generation * Setup and maintained a high level of efficiency in managing "new" accounts * Negotiate pricing and fee structure while ensuring the continuation and enhancement of services * Maintained and added to "new" cu...

Tags for this Online Resume: Inside Sales, Customer Service, Dev OPPs, Portfolio Management, Sales, Inside Sales, Services, Operational Excellence, Enterprise Software, Management, Software, Telephony, Account Management, sales representative, account executive, inside sales, account manager, business development

Senior Business Analyst -15 years Experience - Columbia

Professional Summary Dynamic and motivated IT Senior Business Analyst with experience in client relations, team management, healthcare IT infrastructure and clinical data exchange. and Key Accomplishments Senior Business Analyst with strong healthcare analytic, design and implementation skills. Supported BlueCross BlueShield of South Carolina's TRICARE (military healthcare insurance) contract. Also acted as company liaison ...

Tags for this Online Resume: Application Programming, Budgetary, Infrastructure, Microsoft PowerPoint, Process Improvement, Programming, Research, Research and Development, Test, Test Plans, it jobs, agile, software

Manager - 0 Years of Experience

Total Work Experience 8 years. Working as Project Coordinator / Certified Scrum Master guiding team on methodologies, tasks, dependencies, risks, deliverables and other issues through life of project. * Gathering and updating project materials, completing budgeting, forecasting, project documentation, business flows, and lessons learned documents * Scheduling and allocating work, providing advice and guidance, and resolvin...

Tags for this Online Resume: Applications, CICS, Coding, Management, Progress, Support, Ad hoc reporting, Claim Processing, Data Analysis, Data Reporting

Not Listed - 0 Years of Experience

Business Analyst with more than seven years of experience planning, designing, training, implementing new software systems, writing business rules, documentation, and meeting with clients and internal personnel. Subject Matter Expert in Healthcare and EDI Solutions software. Possesses strong product and technical knowledge, communication skills, and organizational skills. Demonstrated ability to work both independently, re...

Tags for this Online Resume: Managed Care, Root Cause Analysis, IBM MQSeries, Business Analysis, Business Analyst, Health Insurance Portability And Accountability Act, Jad, SCRUM, Scrum Agile Methodology, Agile

Featured Profile

Manager - 20 Years of Experience - Near 48009

Executive level healthcare information technology (IT) expert with experience in multiple segments of healthcare, insurance, and government including client-facing leadership, application implementations and systems integration as well as solid, proven project management skills, and managing diverse project teams; prepared to assist your organization exceed its goals via actionable application of variety of skills in busine...

Tags for this Online Resume: Lawson, Procurement, HR, Human Resources, Management, Mobile Supply Chain, Supply Chain, Application Support, Infection control, Nursing

Business Analyst

Tags for this Online Resume: Agile, Agile methodology, Applications, Cognos, Documentation, Enterprise Applications, Management, Structured Query Language, Automation, Benefits